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Although I had long been fascinated by the strange outlook on health and illness espoused by chiropractors, my personal experience had been limited to two visits for treating (unsuccessfully) a backache. So I was only too happy to respond to an offer for a free "examination and consultation."
In 1994, I accepted an invitation from a local chiropractor who used a telemarketing scheme. The caller suggested that "everyone suffers from stress, and chiropractic is a viable way to deal with it." Two sessions with the chiropractor were required. The examination was to be followed by a consultation the next day. I made the appointment and surreptitiously made an audiotape of the proceedings. There was, of course, no chance that I would be tempted to sign up, but I did feel a need to satisfy my curiosity.
The whole thing turned out to be a smoothly orchestrated attempt to inveigle respondents into committing for an extended series of appointments. I feigned ignorance of chiropractic theory at all times, asking questions as I deemed appropriate and concealing any negative reaction to what I was told. Here's what happened.
The First Visit
Upon entering the office of "Jane Doe, D.C.," I noticed an abundance of chiropractic literature in the waiting room. In addition to the standard brochures extolling the miracles of chiropractic, there were coloring books and other literature intended to entice parents to commit their children to chiropractic. Quite a few crayon drawings were posted on the walls (the practice seemed largely geared at the pediatric market) and a large folder called "Children Need Chiropractic Too!" was available for parents to take home. Also particularly disturbing was a handout for PCS Counseling Service (Psychotherapy Connecting with Spirituality), purportedly a nonprofit corporation with offices in Chicago and suburbs. I sensed that Dr. Doe had an affinity for the mystical and occult, but I never had occasion to discuss the subject with her.
During the registration process, the receptionist asked for my insurance card. Although I was there for a free appointment, she said that this was standard procedure and that she wouldn't bill me.
Dr. Doe was a young, very attractive woman with a pleasant, professional manner. She introduced herself and recited standard chiropractic litany about the importance of the nervous system while demonstrating a model of the spine. She asked if I had seen a chiropractor in the past, and I mentioned my previous negative experience in which I was unable to straighten up for several days after being "adjusted." Ignoring the fact that I had been invited for a free examination, she asked if I was there to have a checkup and to see if I have any subluxations. Then she inquired about headaches and various other aches and pains. (Later, this question seemed superfluous because, at our second meeting, she downplayed the importance of symptoms.) She also asked about my aches, pains, stiffness, etc., and whether I ate "good" food or "junk" food. Her statements about chiropractic included:
My physical exam included a posture checkup in which she pulled hard on my legs, then had me take a few steps back and forth while she checked various movements of my legs. During this procedure, she asked if was experiencing any discomfort. Next she checked my arm and leg reflexes and tapped me in a few places with an instrument that resembles a tuning fork. While feeling my neck she said she noticed something amiss. (I have chronic neck pain, although I didn't tell her so at this at this time.) She had me turn my neck right and left as far as I could, mentioning that she saw a limited range of motion. As I lay on the table she pulled my legs in various directions.
When this was done, she said she had found no misalignments in my lower back and said "the stuff that's going on is all through" the upper back and neck areas." Finally, she took two neck x-rays and instructed me to return for an evaluation of her findings.
The consultation took place the following day in Doe's private office. This was the visit to discuss the findings of the examination. A document on the wall stated that she was certified as an applied kinesiologist.
At this time I decided to mention to her, to check her reaction, that I had been experiencing some constrictions and pain in the upper left chest area. This was true. They began the previous spring and I had had a number of medical tests (following a night in the hospital where I was admitted from the emergency room) to diagnose the problem. No heart problems were found; the problem was later determined to be a hiatial hernia. I also have asthma. Dr. Doe asked whether I had been medically evaluated and said she was glad I mentioned my symptoms. "Very often, as a result of certain things, you do have restriction in your rib cage due to some thoracic problems -- and that can definitely have an effect on your ability to breathe. . . . Asthma has to do sometimes with the nerves going to the lung and the chest cavity movement." She asked for a description and location of the pain.
Displaying my x-ray films, she said: "Let's go over the findings. There were some good things ... and some not so good things." She explained that one of the good things is that she found some correctable problems with my spine that might be related to my symptoms. Less good was the range of motion in my neck, but that wasn't too terrible. Also, my chest movement was "a little bit decreased. Other than that, you're doing relatively well, considering." (Considering what?) Also I'm a little overweight. (True). "Your neck shows relatively well-maintained curvature ... and the beginning signs of some arthritis." (A couple of years ago MRI and Cat Scans showed no signs of arthritis in the neck). She used terms like "degeneration" and "disc decreasing." "You actually have some arthritic stuff going on," which would explain my limited range of motion. My "bio-mechanics" and "center of gravity" were "off."
She then took me to a hands-on display that showed what parts of the body are affected by my specific subluxations. I was instructed to push various buttons that correspond to my problems as shown in the examination and pictures, so there would be "no grand mystery as to why you may have some of the difficulties."
Next she showed me some charts that explained the five phases of cervical degeneration. This appeared to be designed to frighten patients into taking care of the corrections before it is too late. She said that I was fortunate in that it wasn't so bad that she couldn't help. She said I could stop the degenerative process "by keeping the spine mobile and correcting the misalignments."
Next came the explanation of the phases of care: active or acute; corrective; rehabilitation/strengthening; and maintenance (which would continue indefinitely). There would no way to tell whether maintenance requires treatment every three months, every month, or every week. Every patient is different. The first phase (active) is likened to orthodontic braces and requires daily[!] treatment for two weeks. When I asked what the treatment was, she replied, "Primarily, we adjust the spine. We get in there and manually correct the spine and therefore it improves the flow of energy and takes the irritation away from there." Next she asserted that, "Lack of 100% function is lack of 100% health" and that chiropractic is preventive in nature, trying to keep everything working properly.
After the two-week active phase there would be another examination. "Hopefully from that time we are out of the active phase and somewhere through the corrective phase. In the corrective phase, the adjustments start holding themselves ... and your body starts getting used to the new positioning and proper function." Then would come eight weeks at three times per week. There would be another re-exam at six weeks, maybe with x-rays. Progress would be discussed. Then would come spinal and foot exercises. Diet would be reviewed and any necessary supplements prescribed. Nutritional analysis might be indicated if the body does not respond to adjustments.
Although chiropractic adjustment was most important, Dr. Doe also uses electrical stimulation, moist heat, intersegmental traction (using a roller table), and ultrasound. She would take chest x-rays before beginning my particular therapy.
At one point she metnioned that most of the world is "symptom oriented," but she was not:
What we try to do, as what we talked about, is try to get optimal health or wellness. When you're talking about wellness, you don't always have symptoms, but you're not 100% well, or healthy. So if you gear yourself on symptoms, you sometimes miss some very important beginnings of problems. So, as though we want people to be symptom free, since it's no fun to have any discomfort. Sometimes we have patients come in, once they're on maintenance, they're not in any pain any more, they're coming in just to make sure that we check their spine and their subluxations . . . so their bodies function better. Yes, people come in with symptoms but we try to educate them and teach them that symptoms and pain is only one of the things that shows up, it's usually the last thing to show up when there's a problem. These things are there way before there's any pain or discomfort. And usually the pain and discomfort are the first thing that go away and the problem is still there.
She said that I could start therapy as early as that day. Then she sent the office manager in to explain the financial aspects. The office manager had already, without clearing it with me, phoned my insurer ask how much they would pay. She asked if I was ready to begin, but I declined.
Dr. Doe seemed to genuinely believe in the chiropractic platitudes she expressed. But I do not.
Mr. Youngmann, a consumer advocate, is retired restaurateur who resides in Northbrook, Illinois. He became interested in health and nutrition issues while in the foodservice business. Later he became concerned about chiropractic claims. A long-time member of the National Council Against Health Fraud, he lectures from time to time on how to spot and avoid quackery.